title: Cochlear implantation and cardiac associations.
abstract: BACKGROUND
  Cochlear implantation is a safe surgery for restoration of hearing in profoundly deaf candidates. Profound deafness may at times, manifest as a part of a syndrome associated with cardiac anomalies. Cardiac co-morbidities may influence cochlear implantation in a spectrum of ways from minor intra operative issues to major life threatening complications. Issues related to pre operative, intra operative and post operative care needs to be addressed by an efficient in house cardiologist.
  
  
  OBJECTIVE
  Our retrospective study was aimed at analyzing the various cardiac co-morbidities encountered in 30 out of 500 cochlear implantees over a period of 14 years (July 1999-June 2012). This study was focused on developing a profile of cardiac complications influencing cochlear implantation and suggests a protocol for management of various cardiac issues related to cochlear implantation. Our article also reflects the cardiologist's perspective of peri-operative care to be given during cochlear implantation. Relevant literature has been reviewed.
  
  
  METHODS
  Case series of 30 profoundly deaf children (below 12 years) who had associated cardiac problems and underwent cochlear implantation in our institution were included in our study. Overall cardiac disease was identified in 30 out of 500 implantees (16.6%) in our experience. The cardiac disease can be categorized into 3 groups: candidates with isolated Patent Ductus Arteriosus (PDA) as Group A (8/30), candidates with syndrome and other anomalies with PDA association as Group B (18/30), and candidates with syndromes without PDA association as Group C (4/30).
  
  
  RESULTS
  The overall incidence of cardiac problems in profoundly deaf candidates is identified. Descriptive profile of the same has been created and appropriate management for the same described.
  
  
  CONCLUSIONS
  A protocol for management of cardiac co-morbidities influencing cochlear implantation has been designed and detailed insight for the optimal management of these issues has been discussed with cardiologist's perspective.
authors.affiliation: Madras ENT Research Foundation, Chennai, India. drasv77@gmail.com
authors.forename: Arumugam
authors.initials: A
authors.lastname: Senthil Vadivu
authors.forename: Raghunandhan
authors.initials: R
authors.lastname: Sampath
authors.forename: Vijaya Krishnan
authors.initials: VK
authors.lastname: Paramasivan
authors.forename: Madhan
authors.initials: M
authors.lastname: Mohan
authors.forename: Mohan
authors.initials: M
authors.lastname: Kameswaran
mesh_terms: D002648:Child; D002985:Clinical Protocols; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000601:surgery; D029593:Jervell-Lange Nielsen Syndrome / Q000150:complications* / Q000601:surgery; D008297:Male; D019990:Perioperative Care; D011666:Pulmonary Valve Stenosis / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies
keywords: Cardiac co-morbidities; Cardiac pace maker; Cochlear implant; Jervell Lange Nielsen syndrome; Patent Ductus Arteriosus